应用传统超声和多普勒组织显像检测单纯性肥胖小儿左心结构和左心功能  

Examination of left ventricular structure and function in children with simple obesity by using conventional echocardiography and Doppler tissue image

作　　者：毛霞[1,2] 马沛然[1,2] 金超[1,2] 牛峰海[1,2] 寻文龙[1,2] 汪翼[1,2] 韩秀珍[1,2] 

机构地区：[1]山东省立医院儿科 [2]山东省医学影像研究所

出　　处：《中国当代儿科杂志》1999年第2期71-74,共4页Chinese Journal of Contemporary Pediatrics

摘　　要：目的明确儿童期单纯性肥胖对心血管系统的影响。方法应用传统超声和彩色多普勒组织显像技术（ＤＴＩ）全面检测６３例７～１４岁中重度单纯性肥胖儿童及６３例正常体重对照儿童的左心解剖和功能，并分析其与肥胖程度的关系。结果①肥胖组左室舒张内径、室间隔和左室后壁厚度、左室心肌重量（ＬＶＭ）显著增加（Ｐ＜０．０１），而ＬＶＭ指数（ＬＶＭＩ，ＬＶＭ／体表面积）无明显变化（Ｐ＞０．０５）；搏血指数和心脏指数显著降低（Ｐ＜０．０１）；二尖瓣环血流速度Ａ峰，Ｅ／Ａ，左室后壁舒张早期内外膜运动速度差值（ＤＭＥ），二尖瓣环舒张早期运动速度（ＤｅＶ），舒张晚期运动速度（ＤａＶ），舒张早晚期运动速度比（ＤｅＶ／ａＶ）均有显著改变（Ｐ＜００１）。②ＬＶＭ与体重和皮脂厚度均有显著相关性（Ｐ＜００５）；女性肥胖儿童的体重和皮脂厚度与ＤｍｅＶＧ，ＤａＶ，ＤｅＶ／ａＶ均有显著相关性（Ｐ＜００５）；男性肥胖儿童体重与ＤａＶ，皮脂厚度与ＤａＶ，ＤｅＶ／ａＶ有明显相关性（Ｐ＜００５）；腰臀比与左室肥大和左心功能减低均无相关性（Ｐ＞００５）。③ＬＶＭ与ＤａＶ，ＤｅＶ／ａＶ有明显相关性（Ｐ＜００５）。结论早期的单纯肥胖即出现了左室肥厚和左心功能减?Objective To identify the effect of simple obestity on cardiovascular system in children. Methods Left ventricular(LV)structure and function were examined with conventional echocardiography and Doppler tissue imaging techniques in 63 children aged from 7 to 14 years with moderate or severe simple obesity (obesity group) and 63 normal weight children of similar age, height and sex proportion (control group).The relationship between LV structure and function and the degree of obesity was analyzed. Results ①LV diastolic dimension(LVDD),interventricular septal thickness(IVS),LV posterior wall(LVPW) thickness and LV mass (LVM) in obesity group increased significantly as compared with control group ( P <0.01), while LVM index(LVMI)had no obvious change ( P >0.05). Stroke index(SI)and cardiac index(CI)decreased significantly ( P <0.01).There were marked changes in transmitral peak flow velocity during the late atrial filling (A peak),E/A, the motion velocity gaps between LV posterior wall's endocardium and epicardium during early diastolic period (DmeVG), mitral annular early and late diastolic velocity (DeV and DaV), and DeV/aV( P <0.01). ② In obesity group, LVM and some indices about diastolic function showed a correlation with body weight and subcutaneous fat thickness ( P <0.05), but no relationship with the ratio of waist to buttock ( P >0.05). ③ LVM was linearly related to DaV and DeV/aV( P <0.05). Conclusions Obesity in children causes left heart hypertrophy and reduces heart function which is correlated with body weight and subcutaneous fat thickness. LVMI has little change in obese children, which differs from adult obesity. Because childhood obesity is characterized of peripheral fat distribution, the ratio of waist to buttcock is not associated with LV hypertrophy or decreased heart function.

关 键 词：左心功能 单纯性肥胖 相关性 左室 LVM 超声 皮脂 体表面积 外膜 体重 

分 类 号：R544.1[医药卫生—心血管疾病] R541[医药卫生—内科学]